Revenue Integrity Analyst - PPG Revenue Cycle

JOB SUMMARY

• This position contributes to and supports the revenue cycle's mission of strengthening the interface between clinical departments and the charge improvement process. tI is a holistic approach that guides the organization toward achieving operational efficiency, complete regulatory compliance, and total reimbursement. Under the direction of the Manager of CBO, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results. This position is integral to the Revenue Cycle Team to ensure patient services are accurately charged, appropriately coded, supported by clinical documentation, and that the related revenue is recorded in the proper department. In turn, this promotes revenue enhancement and compliance with laws and regulations with feedback and education to the hospital departments as needed. This position assists Revenue Cycle Services, Coding, Clinical Documentation Improvement (CDI), and other departments with the resolution of billing issues and/or denials requiring clinical expertise, participating in external audit requests, CDM maintenance, and special projects as needed. This position also serves as an audit outcome educator with clinical staff in clinic and department settings.

GENERAL REQUIREMENTS

WORKING CONDITIONS

• May be required to change from one task to another of different nature without loss of efficiency or composure.

• Periods of high stress and fluctuating workloads may occur.

• May be scheduled as needed including overtime.

• General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.

• May be exposed to high noise levels and bright lights.

• May be exposed to limited hazardous substances or body fluids, or infectious organisms.

EDUCATION REQUIREMENTS

• 4 year Bachelor's Degree in Healthcare, Business, Finance, Information Systems or a related field. In lieu of bachelor's degree, six (6) years of related Revenue Cycle experience may be substituted in addition to the seven years of minimum experience required. (Required)

EXPERIENCE REQUIREMENTS

• 7-10 years' experience in the hospital setting, healthcare industry or coding with a focus on one or more of the following areas: coding, charge integrity; charge reconciliation; charge compliance; charge auditing; CDM management. (Required)

CERTIFICATIONS AND LICENSURES

• Required Certifications/Licensures: Applicable professional certification through AHIMA (RHIA, RHIT,CCS) or AAPC (COC, CPC), RN or LPN with Coding

GENERAL SKILLS

• Organizational Skills

• Communication Skills

• Interpersonal Skills

• Customer Relations

• Mathematical

• Analytical

• Grammar / Spelling

• Read /Comprehend Written Instructions

• Follow Verbal Instructions

• Basic Computer Skills

• General Clerical Skills

PHYSICAL REQUIREMENTS

• Have near normal vision

• Clarity of vision (both near and far), ability to distinguish colors

• Have good - manual dexterity and eye-hand-foot coordination

• Ability to perform - repetitive tasks/motion

PHYSICAL DEMANDS

• Pushing/Pulling

• Occasionally within shift (1-33%)

• Lift/carry up to 20 lbs

• Occasionally within shift (1-33%)

• Lift/carry > 20 lbs with assistance

• Occasionally within shift (1-33%)

• Reaching above shoulder

• Occasionally within shift (1-33%)

• Lift/carry > 50 lbs with assistance

• Occasionally within shift (1-33%)

• Bending/Stooping

• Occasionally within shift (1-33%)

• Twist at waist

• Occasionally within shift (1-33%)

• Walking

• Occasionally within shift (1-33%)

• Standing

• Frequently within shift (34-66%)

• Climbing

• Occasionally within shift (1-33%)

• Sitting

• Frequently within shift (34-66%)